The role of Diagnostic laparoscopy in Assisting selection of the Most efficacious management of Solid organ injuries following Blunt abdominal trauma
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Favorable results following selective non-surgical management of blunt injuries to both the liver and spleen have been reported extensively by many authors. Diagnostic laparoscopy (DL) was done in an attempt to assess more fully the nature of the organ disruption, the rate of ongoing hemorrhage, to evaluate the associated occult injuries and to assist in patient selection for either conservative management or laparotomy. A total of 27 patients with 30 solid organ injuries (SOIs) were included in the above outlined protocol and underwent DL, which was successfully performed in all Of them. No patient experienced haemo dynamic instability or any other complication attributed either to the laparoscopy or pneumo peritoneum. DL allowed for the inspection of 27 injuries of the spleen and liver, and a suspected renal injury, with failure to visualize two splenic injuries. An associated occult hollow viscus injury was demonstrated at the same time. Fifteen patients out of the 27 studied patients were managed conservatively because of findings with minor injuries with acceptable hemostasis on DL. Twelve patients required laparotomy because of extensive parenchyma! disruption, ongoing hemorrhage and associated occult bowel injuries. All patients selected for conservative management were successfully treated without any failure. No major early complications or any late complications were reported. We conclude that DL has a benefit in the diagnosis and management of SOI following blunt trauma to the abdomen.